Organization
OSNABROCK COMMUNTIY LIVING CENTER INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH NELSON (ADMINISTRATOR)
(701) 496-3131
Entity
Organization
Contact information
Practice address
326 RAINBOW RD, OSNABROCK, ND 58269-6901
(701) 496-3131
(701) 496-3133
Mailing address
326 RAINBOW RD, OSNABROCK, ND 58269-6901
(701) 496-3131
(701) 496-3133
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
8096
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000030706
—
ND
01
—
070765246
DUNS
ND
01
—
8096
BASIC CARE LICENSE
ND
Enumeration date
06/11/2013
Last updated
04/30/2014
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